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Find A Physician
Online Physician and Provider Directory
Services
Printable Directory
Map
About
Learn More About IPPI
Our Mission
Board of Directors
Mailing List Signup
Frequently Asked Questions
IPPI Operating Agreement
Home
Contact Us
Sponsors
News
Events
Membership
Membership Benefits
Join IPPI Now
Marketing Samples
IPPI Benefits Exchange
Employee Benefits
1
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2
Membership Address
3
Payment
IPPI Membership Application
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Physician Membership (100% Independently Owned Practice)
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Please select
Physician - Associate Membership (non-voting)
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Provider Membership (100% Independently Owned Practice)
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Please select
Service for Doctors and Providers (100% Independently Owned) Listing Only
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Please select
Service for Doctors and Providers (Independent or Not) Supporter
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Please select
How did you hear about IPPI? If it was another physician or doctor, please provide that person's name
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Payment summary
No of Doctors to join IPPI with full membership :
* $500 =
$
No of Doctors to join IPPI with no voting rights :
* $250 =
$
No of Provider Membership (100% Independently Owned Practice):
* $500 =
$
No of Service for Doctors and Providers
(100% Independently Owned) Listing only :
* $500 =
$
No of Service for Doctors and Providers
(Independent or Not) Supporter :
* $2500 =
$
Total payable :
$
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Primary Membership Contact Information
First Name
Last Name
Company Name
Address 1
Address 2
Cell Phone
Office Phone
City
State
Zip code
This medical practice is 100% physician/provider-owned?
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